Evidence map›Paper›PMID 42070219›Full record

ArticleJournal of anesthesia2026

Two‑stage diphenhydramine improves early recovery in women after video‑assisted thoracoscopic surgery: a randomized controlled trial.

Jian-Wei Yin, Jie Yin, Si-Si Yang, Xi-Yuan Duan, Chao Zhang, Qing-Ran Wang, Liang He

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In one paragraph

Article in Journal of anesthesia, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors.

Jian-Wei Yin *Department of Anesthesiology, Yan'an Hospital of Kunming City, the Affiliated Yan'an Hospital of Kunming Medical University, Kunming, 650051, China.
Jie Yin *Department of Anesthesiology, Kunming Hospital of Traditional Chinese Medicine, Kunming, 650500, China.
Si-Si YangDepartment of Anesthesiology, Yan'an Hospital of Kunming City, the Affiliated Yan'an Hospital of Kunming Medical University, Kunming, 650051, China.
Xi-Yuan DuanDepartment of Anesthesiology, Yan'an Hospital of Kunming City, the Affiliated Yan'an Hospital of Kunming Medical University, Kunming, 650051, China.
Chao ZhangDepartment of Anesthesiology, Yan'an Hospital of Kunming City, the Affiliated Yan'an Hospital of Kunming Medical University, Kunming, 650051, China.
Qing-Ran WangDepartment of Anesthesiology, Yan'an Hospital of Kunming City, the Affiliated Yan'an Hospital of Kunming Medical University, Kunming, 650051, China.
Liang HeDepartment of Anesthesiology, Yan'an Hospital of Kunming City, the Affiliated Yan'an Hospital of Kunming Medical University, Kunming, 650051, China. hauliang@163.com.ORCID http://orcid.org/0000-0001-7246-4072

Funding

Chuncheng Youth Top-notch Talent Support Program C202014009Kunming Health Science and Technology Talent Program 2024-SW(Reserving)-22
6 · The paper itself

Abstract

purposeThoracic paravertebral block (TPVB) provides effective analgesia for video-assisted thoracoscopic surgery (VATS). However, even when pain is well-controlled by TPVB, female patients remain at high risk for postoperative nausea and vomiting (PONV) and sleep disturbances because of non-analgesic factors, such as hormonal and central emetic pathways. We investigated whether adding a two-stage diphenhydramine regimen to TPVB-based multimodal analgesia improves early recovery quality.

methodsIn this prospective, randomized, double-blind, placebo-controlled trial, 80 women (ASA I-III) scheduled for elective VATS pulmonary resection were randomized to receive a two-stage diphenhydramine regimen (0.2 mg/kg bolus at chest closure followed by 0.5 mg/kg via postoperative patient-controlled intravenous analgesia [PCIA]) or placebo (normal saline). All patients received standardized TPVB with 20 mL 0.4% ropivacaine, PCIA with sufentanil/ondansetron, and intravenous dexamethasone 10 mg. The primary outcome was the 24-h Quality of Recovery-15 (QoR-15) score. Secondary outcomes included sleep quality, PONV incidence, pain scores, rescue medication requirements, and adverse events.

resultsThe diphenhydramine group exhibited a significantly higher median 24 h QoR-15 score (127 [IQR 121-134.75] vs. placebo 119.5 [IQR 108.25-130.75], P = 0.033). This group also demonstrated markedly better sleep quality (lower Athens Insomnia Scale scores at 24 and 48 h, P < 0.05) and a significantly reduced incidence of vomiting (10% vs. 40%, P = 0.004). Overall PONV rates and other secondary outcomes were comparable, with no difference in adverse events.

conclusionsAdding a two-stage diphenhydramine regimen to TPVB-based multimodal analgesia significantly improves early recovery quality, enhances postoperative sleep, and reduces vomiting in women after VATS, without increasing adverse events. CLINICAL

trial registrationChinese Clinical Trial Registry (ChiCTR2500097837).

Indexed as

DiphenhydramineEnhanced recovery after surgeryMultimodal analgesiaThoracic paravertebral blockVideo-assisted thoracoscopic surgery

Identifiers

PMID42070219

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.